“Some lady left this card,” my neighbor told me. “She said if I needed help, I should call. But I don’t need help.”
The card identified a city social worker, and kindled in me a familiar twinge of hope that was swiftly followed by an even more familiar sense of powerlessness.
Does my neighbor need help? That’s true and not true depending upon your definition of “need,” and of “help.”
She lives in a house that she owns. She has clothing and access to food and health care. It is also true that she mostly eats cold cereal and her cheeks are sunken, her legs stick-thin. Her home is cold and dirty with pet-stained rugs and leaking ceilings, her oversized sweaters and shoes are ragged. She occasionally takes prescriptions that are years out of date and, in the years I’ve known her, she has relied upon urgent care or the emergency room to treat everything from a severely infected cat bite to a mysterious pain she feels certain is cancer.
On more than one occasion, she has cried in my arms.
My neighbor is just one person in a rapidly growing state population of older adults that the California Department of Aging projects will reach 11.4 million — roughly 28% of the population — by 2040.
Over the past 15 years, as my children have lost teeth, gotten braces, sprouted acne, grown tall, written college application essays, and flown my nest, I’ve grown more and more aware of my own shifting spot on the timeline. One of my neighbors died at home in the care of her adult son, another moved to assisted living after her husband passed away. A third spent the last decade of her life as the charge of a live-in family hired by a daughter who lived out of state. My neighborhood is a constant reminder that there is no typical aging situation. The process is as individual as it is dynamic, and conditions can change in a heartbeat.
“The best advice I can give to families and older adults who don’t have families,” said Akila Gibbs, director of the Pasadena Senior Center, “is to make a plan. I’m glad we had a plan for my mom because when the dam broke, we knew what she wanted.”
A plan for aging
Jumpstart the conversation with the five Ws:
- Who will be able to make medical decisions and manage finances?
- What are the most important issues for the older person?
- When should these plans escalate from one level of care to the next?
- Where does the older person wish to live?
- Why make a plan at all?
My neighbor’s plan is to live in her house until she dies. She hasn’t really thought about who will inherit her house, but she worries constantly that someone will steal it. She keeps her important papers shuffled into stacks with junk mail and empty envelopes with decades-old postmarks, and prefers the advice of strangers and neighbors over that of family.
It was on her behalf that I first began to investigate aging services. In California, available programs differ from county to county. Myriad offerings are often dictated by the very specific needs of the community. Click on the “Find services in my county” page of the California Department of Aging website. This state organization acts as mothership to 33 Area Agencies on Aging (AAAs), 11 Caregiver Resource Centers (CRCs), and 37 Multipurpose Senior Services Program sites (MSSP). The site is also home to numerous articles on a variety of subjects including mental health and older adult LGBTQ+ resources. A downloadable printed version of the Aging in California resource guide is available in English, Spanish, Chinese, Korean, Vietnamese and Tagalog.
Susan DeMarois, director of the California Department of Aging, said, “Whether an older adult needs home-delivered meals because they don’t have transportation or they visit a senior center to take advantage of the exercise classes, meals, interest groups, and companionship, free services are available to meet the needs of California’s diverse older adult population.”
Researching available programs and navigating websites and systems can add stress to those already attempting to balance work, childcare, and other responsibilities. Many organizations offer assistance free of charge. Answers to questions pertaining to Medicare and Medi-Cal may be found at California Department of Aging Health Insurance Counseling and Advocacy Program (HICAP).
Helplines at Alzheimer’s Orange County and Alzheimer’s Los Angeles can answer many questions about dementia and caregiving as well as connect you with other services, such as respite care and support groups.
“The truth is that many of our support services for older adults are fragmented,” said Kim Bailey, programs and education specialist at Alzheimer’s OC. “There’s a new trend that revolves around trying to engage with a care navigator — someone who can help individuals communicate better with their care providers, work to develop a care plan and coordinate all of these services.” Care navigators may be available pro bono or at reduced fees through your local nonprofit or community center, but are also available for private hire.
Elizabeth G. Malloy, LCSW, CMC, a Los Angeles aging consultant, considers herself (among other things) an organizer, planner and counselor. “I’m filling in the cracks,” she said. “And there is always advocacy. It’s a critical piece.” Having cared for her mother and stepmother at the end of their lives, she recognizes the frustrating mystery of the system and understands the importance of having an ally. “Most people who do what I do come into this because they’ve been on the other side.”
Even the most well-meaning ally can only go as far as the aging adult will allow. My neighbor is happy to accept a quesadilla fresh off my comal, a ride to the bank or market, or a few cans of dog food, but she draws the line at doctor’s appointments and other evidence of what she calls “meddling.” She lets me know when social workers come to her door, and she smiles when she relates how very politely she denied them entrance.
On these chilly days, I look for lights in her windows and monitor the amount of leaves in front of her house. Because she’s handy (and happiest) with a broom, I know a clean sidewalk is evidence of my friend’s relative health and wellness.
RESOURCES
NATIONAL
- Center on Elder Abuse & Neglect
- ElderCare Locator, 800-677-1116
- National Center on Elder Abuse
- National Clearinghouse for Long-Term Care Information
- National Consumers League Fraud Center
- National Council on Aging
- National Elder Fraud Hotline, 833-372-8311
- National Institute on Aging
- SAGE, Advocacy and services for LGBTQ+ elders
Planning and Support Resources
- Aging Life Care Association, referrals for care navigators
- AARP Prepare to Care guide
- Five Wishes, advanced care planning program
- Let’s Have Dinner and Talk About Death
STATE
- Adult Protective Services
- 24-Hour Hotline: 833-401-0832
- Aging and Disability Referral Line, 800-510-2020
- Caregiver Resource Center
- Council on Aging: Education, case management, family programs
- Department of Aging, California, 800-510-2020
- Department of Healthcare Services
- Provides equitable access to healthcare, help with Medi-Cal, assisted living waiver program and other services.
- Department of Social Services Hotline, 844-538-8766
- Department of Justice, State of California
- Psychology Today Therapist Finder
COUNTY/CITY
- Alzheimer’s Association
- Services, counseling, information and support
- Los Angeles – alzheimersla.org
- Orange County – alzoc.org
- San Diego – alzsd.org
- Center for Health Care Rights, Los Angeles County
- Workshops, fact sheets about Medicare and Medi-Cal
- Los Angeles Park Service Senior Centers
- Orange County faith-based senior programs
- Pasadena Senior Center
- Los Angeles LGBT Center
- LGBTQ Center Orange County